Provider Demographics
NPI:1063644912
Name:BROWN-RAMOS, JENNIFER LEE (ARNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEE
Last Name:BROWN-RAMOS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LEE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:1231 116TH AVE NE STE 950
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3832
Mailing Address - Country:US
Mailing Address - Phone:425-454-3366
Mailing Address - Fax:425-646-5198
Practice Address - Street 1:1231 116TH AVE NE STE 950
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3832
Practice Address - Country:US
Practice Address - Phone:425-454-3366
Practice Address - Fax:425-646-5198
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60102355363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9663071Medicaid